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REVIEW ARTICLE
Year : 2019  |  Volume : 14  |  Issue : 2  |  Page : 343-355

Spinal cord stimulation in pregnant patients: Current perspectives of indications, complications, and results in pain control: A systematic review


1 Department of Postgraduate Program in Health Science, Laboratory of Cellular and Molecular Biology and Bioactive Compounds, São Francisco University, Bragança Paulista; Department of Neurosurgery, Postgraduate Program in Health Science, Institute of Medical Assistance of The State Public Servant (IAMSPE), São Paulo, Brazil
2 Department of Neurology, Santa Paula Hospital, São Paulo, Brazil
3 Department of Neurosurgery, Hospital Santa Paula, São Paulo, Brazil
4 Department of Neurosurgery, Postgraduate Program in Health Science, Institute of Medical Assistance of The State Public Servant (IAMSPE); Department of Neurosurgery, Hospital Santa Paula, São Paulo; Department of Research and Innovation, Laboratory of Cellular and Molecular Biology, Medical School of ABC, Santo André; Department of Neurology, Medical School University Pontifical University Catholic of São Paulo, Sorocaba, SP, Brazil

Correspondence Address:
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Rua Boa Esperança, 267 Apartamento 184 Torre Vitel - Chácara Santo Antônio (Zona Leste) – 03408000, São Paulo, SP
Brazil
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ajns.AJNS_7_18

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Spinal cord stimulation (SCS) has been described as a valuable neuromodulator procedure in the management of chronic medically untreated neuropathic pain. Although the use of this technique has been published in many papers, a question still remains regarding its applicability in pregnant patients. The goal of this paper is to discuss the risks, complications, and results as well as the prognosis of SCS in pregnant patients. We performed a systematic review from 1967 to 2018 using the databases MEDLINE, LILACS, SciELO, PubMed, and BIREME, utilizing language as selection criteria. Eighteen studies that met our criteria were found and tabulated. SCS is a reversible and adjustable surgical procedure, which results in patients that demonstrated a significant effect in the reduction of pain intensity in pregnant patients. The etiologies most frequent were complex regional pain and failed back pain syndromes, which together represented 94% of analyzed cases. The technical complications most frequent were lead migration (3%, n = 1). Regarding the risks, the authors did not show significative factors among the categorical variables that can suggest a teratogenicity, while the maternal risks have been associated to the consequences of technical complications due to, among other factors, improvement of abdominal pressure during pregnancy and delivery. Finally, although there are not significative cohorts of pregnant patients, the procedure is still an effective surgical approach of neuropathic pain associated to lower rates of complications and significative improvement in the quality of life of patients during pregnancy.


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